Provider Demographics
NPI:1780106583
Name:UPLIFT REHAB, PLLC
Entity type:Organization
Organization Name:UPLIFT REHAB, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:GREEN
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP, CLT
Authorized Official - Phone:806-773-2284
Mailing Address - Street 1:750 COUNTY ROAD 413
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-3142
Mailing Address - Country:US
Mailing Address - Phone:806-773-2284
Mailing Address - Fax:
Practice Address - Street 1:750 COUNTY ROAD 413
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-3142
Practice Address - Country:US
Practice Address - Phone:806-773-2284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty